Failure of scabies treatment
Leibowitz, M.R.
New Zealand Medical Journal 106(960): 317-318
1993
ISSN/ISBN: 0028-8446 PMID: 8341460 Document Number: 422255
The failure of gamma hexachloride (HCH) as a treatment for human scabies in New Zealand has been noticed since 1989. Cases were referred by general practitioners for specialist evaluation. A postal survey of 14 dermatologists suggested that at least 9 had encountered resistant scabies. A further survey, where it was known that 10 individuals and 83% of nonsymptomatic household contacts had been treated, suggested resistance to HCH and not reinfestation or non-compliance as the cause of failure in the treatment. A 5% permethrin cream became available in 1992 and several families have been treated since successfully. One patient, however, had viable scabies 10 days after treatment with permethrin. The author's letter is from the south of New Zealand (Southland) and he mentions a recent report from Wellington on North Island which confirms the tolerance of scabies to treatment with HCH. B.R. Laurence Since 1989 resistance of Sarcoptes scabiei to gamma benzene hexachloride has been suspected. A postal survey of 14 New Zealand dermatologists revealed that 9 considered that they had encountered resistant scabies. A small survey, involving 10 individuals and their families, produced results that strongly suggested resistance. As a result of this it was recommended that 5% permethrin be made available in New Zealand. Since April 1992 this has become available and several families have been successfully treated after lindane failure. However, a patient is reported who had viable scabies mites 10 days after permethrin therapy.